Diagnosis of gluten enteropathy and efficiency of its treatment

AIM: To develop screening diagnosis of gluten enteropathy (GEP), indications to administration of glucocorticoid hormones and objective criteria of effective treatment. MATERIAL AND METHODS: Clinical, immunological (antibodies-Abs to alpha-gliadin, reticulin and endomisium) examinations, enterobiopsy with morpho- and stereometry of small intestinal mucosa were made in 200 GEP patients. The examination was repeated 6 months to 5 years and later after the discharge from the hospital. RESULTS: Mean values of Abs to alpha-gliadin was 6 times higher than normal values. Positive titers of Abs to endomisium and reticulin were in 100 and 87.5% patients, respectively. Formed stool was registered 1.5 times more frequently, polyfecalia occurred 2.5 times less frequently, hypovitaminosis and trophic disorders were relieved 3 times more frequently, malabsorption syndrome reduced in patients given prednisolone vs those untreated with it. CONCLUSION: Screening diagnosis of GEP may be based on Abs tests to alpha-gliadin, reticulin and endomisium. Improvement of clinical condition of GEP patients can be stated by decreased diarrhea, polyfecalia and malabsorption symptoms. The treatment efficacy may be judged by clinical improvement, recovery of morphological structure of small intestinal mucosa, normalization of concentration of Abs to alpha-gliadin, reticulin, endomisium. Administration of prednisolone provides more complete and rapid rehabilitation of the patients.